Health and Nutrition Assessment

Which of these areas could you use support with? (Select all that apply.)

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* 1. Which of these areas could you use support with? (Select all that apply.)

Which describes your mind and brain function?

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* 2. Which describes your mind and brain function?

Are you equivalent to your age?

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* 4. Are you equivalent to your age?

How is your mind and brain function?

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* 5. How is your mind and brain function?

How is your eating?

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* 7. How is your eating?

Have you ever done a cleanse?

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* 8. Have you ever done a cleanse?

Rate your stress level.

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* 9. Rate your stress level.

Name & Contact Info

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* 10. Name & Contact Info

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